INRA Research Director
Joint Research Unit for Nutrition, Obesity and Risk of Thrombosis (NORT) INRA–Inserm–Aix-Marseille University
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Although it is accepted that the diet of the most disadvantaged populations does not comply closely with nutritional recommendations, the relationship between budget and a dietary balance is not so simple. The journal Nutrition Reviews has just published a literature review conducted by the Joint Research Unit for Nutrition, Obesity and Risk of Thrombosis (INRA – -Inserm – Aix Marseille University), in collaboration with the University of Washington Center for Public Health Nutrition, on the contribution of food prices to social inequality regarding food choices and nutrition. © Fotolia
At the end of the years 1980-1990, it was known that the most disadvantaged populations had the dietary behaviours least in line with nutritional recommendations, with a lower intake of fruits and vegetables, and a higher intake of refined cereal products (white bread, pasta, white rice, etc.), and perhaps of sweet products. However, these variations in dietary behaviours with socioeconomic status were mainly attributed to educational differences, and few nutritionists focused on the cost of a balanced diet. Thus the first French National Nutrition and Health Programme (PNNS, launched in 2001) was mainly based on large-scale dissemination of nutrition education messages. Subsequently, the impact of food environment (price and availability of foods, advertising, etc.) on food choices was gradually demonstrated, encouraging the development of nutrition policies centred not only on demand (consumer behaviour), but also on the food supply.
In this literature review, the researchers have focused on the economic determinants of food choices. They confirm that when foods are compared on the INCA scale, with price expressed in €/100 kcal (and not in €/kg), products rich in vitamins, iron, calcium and fibre are more expensive sources of calories than energy-rich, high-fat or high-sugar products. Whether along the production chain or for the consumer, products such as crisps, confectionery and biscuits, as well as pasta and rice, are easy to carry, store and prepare, and are non-perishable, which explains why they are cheaper than fresh produce.
Consistent with these observations on foods, a balanced diet generally costs more than an unbalanced diet, making it harder to achieve nutritional balance where budgets are limited.
However, observation and modelling studies show that it is possible to assemble a balanced basket of goods on a modest budget, provided that the latter is equal to or more than €3.5 per day per person. This is possible on condition that one is prepared to depart more from dietary habits and cultural norms, and in particular to consume foods that are of good nutritional quality for their price, such as canned or frozen vegetables.
Studies available to date, and analysed in this review, are based on mean or standard prices, but no-one buys food at the mean price. Over time, segmentation of agri-food markets has made it possible to make products available to consumers at all price levels, from entry level price to premium price, with everyone benefiting from good nutritional quality. It is therefore possible that a balanced diet is now within reach of all. What would be concluded from studies, if real prices were considered and not mean prices?
While awaiting this future research, it is important to take budgetary constraints and differences in food prices into consideration when drawing up dietary advice.
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The contribution of food prices and diet cost to socioeconomic disparities in diet quality and health: a systematic review and analysis.
N. Darmon & A. Drewnowski.
Nutrition Review, 25 August 2015.